Blog Post

Healthcare Upside/Down: Creating a Caring Economy

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ECG’s radio show and podcast, Healthcare Upside Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by ECG principal Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone.

My mother needed help in the latter stages of her life. Thankfully, although she lived alone in a flat, she was not without support. She had neighbors, and she did manage to get out periodically.

But much of the assistance my mother received came from my brother, who lived nearby. He was a tremendous source of support, stopping by every week to help in a multitude of ways—maintaining her house, changing light bulbs, fixing things, and perhaps most importantly, providing company and social support. (The fact he was also a local doctor and family practitioner was a bonus.)

Joining us on episode 33 of Healthcare Upside Down is Alexandra Drane, CEO and cofounder of Archangels.

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I am deeply grateful to my brother for his time and energy. And if the above anecdote rings familiar, it may be because you’ve served in a similar role, or at least know someone who has. In fact, according to this week’s guest, nearly half of the adults in the US serve as unpaid caregivers—a role they don’t often realize they’re playing. “It could be friends, family, loved ones, neighbors, or fellow faith-based community members,” says Alexandra Drane. “What matters most is it’s somebody who’s caring.”

Alexandra is the CEO and cofounder of Archangels, an organization focused on bringing real and lasting impact to our community of caregivers. She joins us on episode 33 of Healthcare Upside Down to talk about examining the language we use to describe the role of unpaid caregivers, the resources available to them, and how employers and communities can provide meaningful support to individuals who toil in a role that is difficult, often thankless, and uncompensated. Here are a few excerpts.

An unpaid workforce.

“When we’re talking about caregivers, we’re talking about unpaid caregivers. That care can take the traditional perspective we think of—’Oh, my mother or father with Alzheimer’s moved in’—but it can be as broad as ‘I’m the one who’s picking up food, I’m the one who’s shoveling the yard, I’m the one who’s making sure that somebody’s light goes off at night and their shades open up in the morning, because I’m looking across the way and I’m ready to leap into action if they’re not. ” People are often surprised to hear that 43% of adults in the US right now are in this role.”

Awareness of resources—and how employers can help.

“Resources do exist. They’re not always titled ‘caregiver support,’ but they might be in the form of Meals on Wheels, access to a social worker, access to financial advice, advice around advanced illness, all the way over to the biggest employers—most have an employee assistance program (EAP). But most people aren’t using these EAPs because they have stigmas associated with them. So part of what we need to do is rebrand these resources so that an unpaid caregiver knows they exist and feels OK, even wonderful, about accessing them. Employers have an extraordinary role to play here. They are increasingly aware that the second most cited reason for somebody quitting their job is because they are an unpaid caregiver. And unpaid caregivers don’t want to quit their job. For most of them, work is respite.”

Identifying as a caregiver.

“What we hear more often than anything else is ‘I’m not a caregiver; I’m just a daughter, I’m just a neighbor, I’m just a friend, I’m just a husband.’ And so if you don’t see yourself in this role, then even if we had a billion resources to support you, you’re not going to avail yourself of them. So job number one is using the term in a positive way. Let’s not just normalize the reality that this role exists for [almost] half the population—let’s celebrate it. Let’s reframe it to say these unpaid caregivers are badass warrior angels.”

On the podcast, Alexandra describes the metrics she uses to calculate the intensity of caregiving, the importance of care navigation, and what it means to create a caring economy.

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